Healthcare Provider Details

I. General information

NPI: 1952023715
Provider Name (Legal Business Name): MEGAN FORD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2022
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 MAIN ST STE 216
CHARLESTOWN MA
02129-1122
US

IV. Provider business mailing address

60 FLORRY DR UNIT 32
DRACUT MA
01826-4025
US

V. Phone/Fax

Practice location:
  • Phone: 617-426-0600
  • Fax:
Mailing address:
  • Phone: 603-233-4771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN2292160
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2292160
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: